Audi::VW Volkswagen::Bentley::Mercedes::Porsche
Please print out form. Fill it out and drop in our after-hours drop box with key.
DATE:____________R.O.#_______________MILEAGE:_______________VIN:______________________
CLIENT INFORMATION
NAME (please print):_____________________________________________________________________
ADDRESS:________________________________________CITY:________________________________
STATE:________________________ZIPCODE:________PHONE:___________MOBILE#_______________
E-MAIL:_______________________How did you hear about us?_________________________________
VEHICLE INFORMATION
MAKE:_________________________MODEL______________________YEAR________TAG____________
COLOR:_____________________PROD.DATE___________________RADIO CODE____________________
ENGINE:____________________________TRANS_____________________________________________
SERVICE REQUESTS
______________________________________________________________
______________________________________________________________
______________________________________________________________
______________________________________________________________
______________________________________________________________
I hereby authorize the above inspections/repairs to be performed along with the necessary materials, and further grant Ringtec Atlanta and
employee(s) permission to operate the vehicle herein described on the streets, highways, or elsewhere for testing and/or inspection purposes.
An expressed mechanics lien is hereby acknowledged on the above vehicle to secure the amount of repairs thereto.
Client signature_____________________________________________________________